Notice of Privacy Practices
How medical information about you may be used and disclosed, and how you can access it.
Effective date: [EFFECTIVE DATE]
Attorney review required before launch.
This page is a drafting template prepared to give the site a
complete structure. It is not legal advice and has not been reviewed by counsel. A
healthcare attorney licensed in California must review, complete and approve it before this site goes
live. Bracketed items marked [LIKE THIS] must be completed.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our commitment
Aries Health and Wellness is required by law to maintain the privacy of your protected health information (PHI), to provide you with this notice of our legal duties and privacy practices, and to abide by the terms of the notice currently in effect.
How we may use and disclose your health information
- Treatment — [DESCRIBE, WITH AN EXAMPLE]
- Payment — [DESCRIBE, WITH AN EXAMPLE]
- Healthcare operations — [DESCRIBE, WITH AN EXAMPLE]
- Business associates — [DESCRIBE, INCLUDING THE COMPOUNDING PHARMACY, LABORATORY AND OPTIMANTRA]
- As required by law — [DESCRIBE]
- Other permitted uses — [PUBLIC HEALTH, ABUSE REPORTING, HEALTH OVERSIGHT, JUDICIAL PROCEEDINGS, LAW ENFORCEMENT, CORONERS, ORGAN DONATION, RESEARCH, SERIOUS THREATS, MILITARY, WORKERS' COMPENSATION]
Uses requiring your written authorization
Most uses and disclosures of psychotherapy notes, uses for marketing purposes, and any sale of PHI require your written authorization. [CONFIRM AND EXPAND.] Patient testimonials published on this website require signed written authorization before publication.
Your rights regarding your health information
- The right to inspect and copy your record
- The right to request an amendment
- The right to an accounting of disclosures
- The right to request restrictions on certain uses and disclosures
- The right to request confidential communications
- The right to a paper copy of this notice
- The right to be notified of a breach of unsecured PHI
[DESCRIBE HOW TO EXERCISE EACH RIGHT, INCLUDING WHERE TO SUBMIT REQUESTS AND APPLICABLE TIMEFRAMES.]
California-specific protections
[CALIFORNIA'S CONFIDENTIALITY OF MEDICAL INFORMATION ACT PROVIDES PROTECTIONS THAT MAY EXCEED HIPAA IN CERTAIN RESPECTS. TO BE ADDRESSED BY COUNSEL.]
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us using the contact details below, or with the Secretary of the US Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.
[INSERT PRIVACY OFFICER NAME AND CONTACT DETAILS.]
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for health information we already hold as well as any information we receive in future. [DESCRIBE HOW REVISIONS WILL BE COMMUNICATED AND POSTED.]
How to contact us
Aries Health and Wellness
41324 12th St W
Palmdale, CA 93551
Email: arieshealthcorporation@gmail.com